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Question Title Posted By Question Date
Applied Kinesiologist Linda Wednesday, April 25, 2007

Question:

Dear Bro. Ignatius;

I just read the post about "Kinesiology". Our family has been going to a Chiropractor that went on for further training in "Applied Kinesiology". He never mentions these "energy" pathways to us when he is giving us adjustments but he has charts on his office walls showing the Meridiens. He doesn't do Acupuncture or anything New Age. His adjustments seem to be just of a chiropractic nature. He's always telling us to drink more water and eat less sugar. He sells vitamins, water pillows, pillows shaped for your neck, no crystals or other way out stuff. Is it possible for a Chiropractor to just do adjustments to your body/muscles and not do these other things? Would it be alright to go to him in that case?



Question Answered by Bro. Ignatius Mary, OLSM

Dear Linda:

It is very difficult to find a Chiropractor who limits his practice to that which is legitimate and scientific. The underlying theory of chiropractic is problematic at best and outright bogus at worse.

To quote Samuel Homola, D.C., who practiced chiropractic for 43 years:

It is now generally accepted that spinal manipulation can relieve some types of back pain. (But) most chiropractors claim to do more than just treat back pain, however. Clinging to the scientifically rejected theory that misasligned or "subluxed" vertebrae cause "nerve interference" that results in disease or ill health, many chiropractors use "spinal adjustments" to treat disease and infection as well as back pain. The Association of Chiropractic Colleges bolstered support for this theory in 1996 when the presidents of all 16 North American chiropractic colleges reached a consensus and issued a position paper stating that "Chiropractic is concerned with the preservation and restoration of health, and focuses particular attention on the subluxation."

The chiropractic profession continues to define itself as a method of correcting subluxations to restore and maintain health, despite the fact that there are no scientific studies to indicate that vertebral misalignment or any other problem in the spine is a cause of disease or infection. Basing their treatment on the vertebral subluxation theory, many chiropractors claim to be primary care physicians capable of treating and preventing a broad scope of human (and animal) ailments.

Some chiropractors advise that spinal adjustments should begin at birth to correct subluxations caused by "birth trauma." The entire family may be advised to undergo regular life-long spinal adjustments in order to maintain optimum health by "keeping the spine in line." Some chiropractors specialize in chiropractic pediatrics. According to the American Chiropractic Association, 10% of patient visits to chiropractors are made by children and adolescents who are treated for such maladies as otitis media, asthma, allergies, infantile colic, and enuresis (bedwetting).  An article in the April 2000 Archives of Pediatric and Adolescent Medicine warned that chiropractic pediatric care is often inconsistent with recommended medical guidelines.  "When I contemplate a chiropractor treating a 2-week-old neonate with a fever," said the editor in a sidebar comment, "I get a gigantic headache."

Studies conducted by chiropractors and published in "peer reviewed" chiropractic journals often recommend treatment for such conditions as infantile colic and asthma. A study published in the Journal of Manipulative and Physiological Therapeutics for example, concluded that "Spinal manipulation is effective in relieving infantile colic" -- a conclusion not confirmed with reliable, unbiased research and recently refuted by a well designed study by a Norwegian research team.

When medical researchers tested chiropractic manipulation as a treatment of asthma in children, they reported that "the addition of chiropractic spinal manipulation to usual medical care provided no benefit." Although chiropractic manipulation can be beneficial in the treatment of some types of neck and back pain, I always advise parents not to take their infants and children to a chiropractor, since the risk may outweigh any benefit.

Chiropractic may have benefit only in limited context, mostly with pain in the back and other issues of neuromusculoskeletal conditions of a mechanical origin. Chiropractors need to be in close relationship with a medical doctor and limit their practice to this relationship and specific practice.

Dr. Homola continues:

Since chiropractors work on the back, most people think of the chiropractor as a back specialist. But when back-pain victims visit a chiropractic office, they may be given pamphlets suggesting that chiropractic treatment is also beneficial for asthma, infantile colic, ear infection, digestive disturbances, and a host of other organic or visceral problems. There are many good chiropractors who do a good job treating back pain, but few voluntarily limit their treatment to the care of back pain. Chiropractic colleges are still teaching the theory that using spinal adjustments to correct vertebral subluxations will restore and maintain health. Unless you see a chiropractor who has been recommended by an orthopedic specialist or who works with physicians in a back-pain clinic, your chances of finding a properly limited chiropractor are slim. Poorly informed consumers may not know where to draw the line when they visit a chiropractor.

"That spinal manipulation is somewhat effective symptomatic therapy for some patients with acute low back pain is, I believe, no longer in dispute," said the editorial in the New England Journal of Medicine. But "there appears to be little evidence to support the value of spinal manipulation for non-musculoskeletal conditions. For this reason, I think it is currently inappropriate to consider chiropractic as a broad-based alternative to traditional medical care."

Dr. Homola offers the following five guidelines and caveats that should be observed when seeking chiropractic care for back pain.

1. Be on Guard

Look for a chiropractor who openly states that his or her practice is limited to the treatment of neuromusculoskeletal problems that have a mechanical origin.

Members of a small group called the Nations Association of Chiropractic Medicine (NACM) have openly denounced the chiropractic subluxation theory, but the chance of finding an NACM chiropractor in your community is small.

If you cannot find a chiropractor who is a neuromusculoskeletal specialist or who works in a back-pain clinic as a member of a back-care team, you have to be on guard as an informed consumer if you are to protect yourself from the nonsense associated with chiropractic treatment. There are many chiropractic procedures and techniques you should avoid -- some of which are dangerous as well as a waste of time and money.

2. Seek Appropriate Manipulation

Properly performed spinal manipulation is always done by hand. Chiropractors who believe that slightly misaligned vertebrae can cause disease often use machines or small hand-held spring-loaded mallets to tap misaligned vertebrae back into place. A 1998 survey by the National Board of Chiropractic Examiners found that 62.8% of survey respondents said they used an Activator mallet to adjust subluxations. Such chiropractors might also use instruments to measure heat and electrical activity over skin surfaces in a search for subluxations. The only treatment they may offer is a spinal adjustment for whatever ails you.

A good chiropractor who specializes in the care of neuromusculoskeletal problems does not use instruments and machines to diagnose and treat subluxations. And his treatment is not limited to the spinal adjustment. Physical therapy, massage, exercise, rest, home treatment with hot or cold packs -or no treatment at all-are sometimes more appropriate than spinal manipulation.

3. Avoid Unnecessary Treatment

While an acute episode of back pain can be incapacitating and scary, remember that most back pains resolve in two to four weeks. After limiting bed rest to a couple of days, most back-pain victims can begin moving around and gradually resume normal activities over a period of a week or two. If you go to a chiropractor for relief of back pain, you should not continue with treatment if your pain worsens during the first week or if you are not any better after two weeks. If your symptoms persist after one month, see an orthopedic specialist for a definitive diagnosis.

A chiropractor who is reasonably competent in making a diagnosis might immediately refer you to a specialist if certain red flags are present, such as: fever; a history of cancer; prolonged back pain unrelieved by rest; the possibility of a fracture resulting from advanced age, long-term use of steroids, or severe injury; and so on. In the case of a simple strain, you might be advised that rest and time are the 'best treatment. But you cannot always rely on the diagnostic ability of a chiropractor. Some chiropractors "analyze" the spine in a search for subluxations rather than make a diagnosis. They always find subluxations that require spinal adjustments. Such chiropractors are less likely to offer appropriate advice and are more likely to subject you to prolonged and unnecessary treatment.

Be wary if your chiropractor's diagnosis is "subluxated vertebrae." Be even more wary if you are given a treatment plan that recommends daily visits that are gradually reduced in frequency over a period of several months. Such plans usually lead into "maintenance care" that requires one or two treatments a month for the rest of your life!

4. Popping Normal Backs

As a general rule, chiropractic treatment, or manipulative treatment for back pain, should be discontinued when symptoms disappear and you are feeling well. It is not necessary to continue with occasional spinal adjustments unless you have a structural problem that causes chronic back pain that can be temporarily relieved with manipulation. Frequent and unnecessary manipulation may do more harm than good, causing you to seek treatment for symptoms caused by the manipulation.

Normal spinal joints often make popping sounds when the joint surfaces are forcefully separated by manipulation.

Chiropractic patients often interpret these sounds as movement of vertebrae that are out of place. Some chiropractors use the popping sound to encourage patients to return for regular spinal adjustments in order to "maintain vertebral alignment." While such treatment has a strong placebo effect, it is misleading and tends to perpetuate illness or fear of illness.

5. "Neck Specialists"

Some subluxation-based chiropractors believe that most ailments, including low-back pain, are related to misaligned vertebrae in the neck. These "upper cervical specialists" always adjust the neck, usually the top two vertebrae at the base of the skull. This can be dangerous, since excessive rotation of the head and upper cervical spine places a strain on the vertebral arteries and can result in vascular injury or stroke.

There are special cases in which cervical manipulation can be beneficial when vascular problems have been ruled out and head rotation during manipulation does not exceed 50 degrees. But cervical manipulation should never be done routinely, especially as a preventive-maintenance measure. Most of us will never need cervical manipulation. Upper cervical chiropractors who manipulate the neck of every patient they see should be avoided. Elderly persons, especially those who have vascular disease or who might be taking blood thinners, should not submit to neck manipulation of any kind.

Finally, Dr. Homola informs us of the dangers of Chiropractic:

A 1996 RAND report on The Appropriateness of Manipulation and Mobilization of the Cervical Spine estimated that stroke and other injuries resulting from cervical spine manipulation occurred about 1.46 times per 1,000,000 manipulations. It also concluded that only 11.1% of reported indications for cervical manipulation could be labeled appropriate. A patient who receives regular, frequent, and totally unnecessary neck manipulation is subjected to greater risk. Since many cases of stroke caused by cervical manipulation have not been recognized as such, studies are being done to determine how many stroke victims had neck manipulation prior to their stroke. The incidence of stroke from cervical manipulation might be much higher than indicated in past studies. A study by the Canadian Stroke Consortium, published in the July 18, 2000, Canadian Medical Association Journal, for example, reported that stroke resulting from neck manipulation occurred in 28% of 74 cases studied. Other causes were sudden neck movement of various types. The most common finding was vertebral artery dissection (splitting or tearing of arterial walls with clot formation and embolism) caused by sudden movement or rotation of the top two cervical vertebrae.

Chiropractors commonly manipulate the upper cervical spine as a treatment for head and neck pain. But since such pain in itself can be a symptom of vertebral or carotid artery dissection, especially following injury, it may be wise to forego neck manipulation for sudden onset of head or neck pain until risk factors can be better identified. Informed consent should always be obtained from patients about to undergo cervical manipulation. In many cases, massage, traction, and other forms of therapy can be substituted for prescribed cervical manipulation. Tension headache, for example, is commonly treated with chiropractic neck manipulation. A study published in the Journal of the American Medical Association found that spinal manipulation was no more effective than massage in relieving episodic or recurring tension headache. So be cautious. Until studies on cervical manipulation have been completed, don't submit to neck manipulation unless you have a problem that cannot be treated any other way. A chronic "cervicogenic" head pain, for example, in which pain is transferred from joints in the cervical spine, can often be relieved with appropriate cervical manipulation. But such manipulation should be done only after a correct diagnosis has been made and other forms of treatment have failed.

Dr. Homola's The Bottom Line:

Many people go to chiropractors for relief of back pain. But there is reason for caution. Much of what chiropractors do is nonsense, and they often misinform their patients.

A good chiropractor can do a lot to help you when you have mechanical-type back pain and other musculoskeletal problems. But until the chiropractic profession cleans up its act, and its colleges uniformly graduate properly limited chiropractors who specialize in neuromusculoskeletal problems, you'll have to exercise caution and informed judgment when seeking chiropractic care.

Now, with all that said, now we go back to your original question.

Chiropractors are often involved in various Oriental alternative medical theories. You have identified that your Chiropractor has received advanced training in Kinesiology. Kinesiology is, by definition, involved in the "energies" theory that I mentioned earlier. The Meridians Chart, if that is what it is, on the wall of your Chiropractor is a map of these fake energy circulatory system.

This means that he is involved, at least philosophically with fake science. But, as outlined above, any Chiropractor who does anything other than deal with neuromusculoskeletal problems for "mechanical-type back pain and other musculoskeletal problems"  should be avoided.

I did not get into it, but there are many other problems, especially with neck adjustments that has cause serious medical problems with many people including stroke and death.

Bottomline is to avoid Chiropractors unless they limit their practice as advised by the quotes above.

God Bless,
Bro. Ignatius Mary


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